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Calcium and phosphate metabolism and disorders in the newborn

Korean Journal of Pediatrics 2007;50(3):230-235.
Published online March 15, 2007.
Calcium and phosphate metabolism and disorders in the newborn
Hae Soon Kim
Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
신생아에서 칼슘 및 인 대사 평가와 질환
이화여자대학교 의과대학 소아과학교실
Hae Soon Kim, Email: hyesk@ewha.ac.kr
In the early neonatal period, the neonate is challenged by the loss of the placental calcium transport and manifests a quick transition, from an environment in which PTHrP plays an important role to a PTH- and 1,25-dihydroxyvitamin D-controlled neonatal milieu. Disturbances in mineral homeostasis are common in the neonatal period, especially in premature infants and infants who are hospitalized in an intensive care unit. In many cases these disturbances are thought to be exaggerated responses to the normal physiological transition from the intrauterine environment to neonatal independence. Some disturbances in calcium and phosphate homeostasis are the result of genetic defects, which in many instances can now be identified at the molecular level. Although fetus develop remarkably normally in the presence of maternal calcium, PTH and vitamin D deficiency, the neonates demonstrate abnormalities that are consequences of the prior abnormal maternal calcium homeostasis. Evaluation and management of hypocalcemia and hypercalcemia in neonate requires specific knowledge of perinatal mineral physiology and the unique clinical and biochemical features of newborn mineral metabolism.
Key Words: Newborn , Hypocalcemia , Hypercalcemia , Parathyroid hormone , Vitamin D

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